Journal of Health, Population, and Nutrition最新文献

{"title":"Comparing TCIM use and patient satisfaction in germany: impact of health self-management across migration backgrounds.","authors":"Steffen Grüll, Jutta Huebner, Gianluca Ciarlo","doi":"10.1186/s41043-026-01395-7","DOIUrl":"10.1186/s41043-026-01395-7","url":null,"abstract":"<p><strong>Purpose: </strong>Cultural background and migration experiences shape health behavior, use of traditional, complementary and integrative medicine (TCIM), and trust in physicians. This study examines how these factors interact in patients in Germany and whether health self-management modifies these relationships. The goal is to inform culturally sensitive, patient-centered care.</p><p><strong>Methods: </strong>Between October and December 2023, 375 patients were surveyed in a monocentric primary care study using an anonymous questionnaire assessing migration background, use of TCIM, health self-management, trust in physicians, and relevant sociodemographic characteristics.</p><p><strong>Results: </strong>A total of 375 patients participated (mean age 50.3 years, 54.5% female), with 19.5% reporting a migration background. Overall patient activation was moderate to high (M = 2.86-3.66, SD = 0.55-0.92), with no significant differences between natives and migrants (Cohen's d = 0.067, Hedges' g = 0.067, Glass' Δ = 0.050). Physical exercise (75.2%), other vitamins/dietary supplements (40.5%), and relaxation techniques (10.9%) were the most frequently used TCIM methods, while mistletoe (1.1%), probiotics (6.1%), acupuncture/acupressure (3.2%), and Reiki (3.2%) were rarely applied. Patient satisfaction was high across all participants (mean range 5.42-6.08 on a 7-point Likert scale), with natives reporting slightly higher scores for general satisfaction and trust in physician competence.</p><p><strong>Conclusion: </strong>Patient activation was moderate to high, with no significant differences between native-born and migrant participants. Lifestyle-oriented TCIM methods were used most frequently, with little difference in usage. Overall patient satisfaction was high, although migrants reported slightly lower confidence and satisfaction. These findings underscore the need for culturally sensitive measures to promote equitable healthcare.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Low carbohydrate diet with anthropometric indexes among overweight and obese women.","authors":"Mehdi Karimi, Farideh Shiraseb, Atieh Mirzababaei, Alireza Khadem, Zeinab Zarrinvafa, Leila Khorraminezhad, Reza Bagheri, Alexei Wong, Khadijeh Mirzaei","doi":"10.1186/s41043-026-01292-z","DOIUrl":"10.1186/s41043-026-01292-z","url":null,"abstract":"<p><strong>Background: </strong>The important association between Low-Carbohydrate Diets (LCD), lipid and glycemic control, and weight loss has been well-depicted in previous research. However, the relationship between LCD, lipid and glycemic profiles, and new anthropometric markers such as the a-Body Shape Index (ABSI) and the Obesity Degree (OD) has not been established. Therefore, this cross-sectional study aimed to investigate the relationship between LCD, lipid, and glycemic profiles, with the ABSI and the OD in overweight and obese women.</p><p><strong>Methods: </strong>A cohort of 290 overweight and obese women (body mass index (BMI) > 25 kg.m^- 2), aged 18-48 years old, were included in this cross-sectional study. The amount of dietary intake and LCD score were established using a valid and reliable Questionnaire of Food Frequency (FFQ) containing 147 items. Body composition was assessed via bioelectrical impedance analysis. The anthropometric measurements and serum profiles were measured by standard protocols. physical activity was also assessed. The ABSI index was also measured by its formula. Models were adjusted for age, energy intake, and physical activity(PA) and BMI.</p><p><strong>Results: </strong>It was observed that higher LCD score was significantly associated with lower OD (p = 0.041); however, no significant relationship was observed between LCD score and ABSI even after adjusting for potential confounders (age, energy intake, physical activity, economic status, education status (p = 0.168). In a linear logistic regression following of LCD score and controlled with potential confounders, a lower level of -0.77 kg, -1.043%, and - 1.98 cm were observed in visceral fat (β = -0.77, 95%CI = -1.51, -0.02, p = 0.049), body fat percentage (β = -1.043, 95%CI = -2.31, -0.22, p = 0.020), and waist circumstance (β = -1.98, 95%CI = -4.01, 0.04, p = 0.044), respectively. In addition, participants with a higher quartile of LCD score, which indicated higher LCD score, had higher high-density lipoprotein (HDL) (p = 0.041) concentrations.</p><p><strong>Conclusion: </strong>A higher LCD score was associated with lower OD, body fat (BF), visceral fat, and waist circumference, and with higher HDL in overweight and obese women. However, there are no associations between LCD and ABSI.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of exclusive breastfeeding levels for the first 6 months on the prevalence of overweight in children under 5 years of age.","authors":"Özlem Kemer Aycan, Kadir Yılmaz","doi":"10.1186/s41043-026-01396-6","DOIUrl":"10.1186/s41043-026-01396-6","url":null,"abstract":"<p><strong>Objectives: </strong>This aggregated ecological time-series data study aimed to investigate the effect of exclusive breastfeeding for the first 6 months on the prevalence of overweight in children under 5 years of age.</p><p><strong>Methods: </strong>The study used data for Turkey from 2000 to 2024, provided by the WHO and also published through World Bank Country Reports. The prevalence of overweight was used as the dependent variable, and exclusive breastfeeding was used as the independent variable. Control variables included the share of health expenditures in GDP (including all confounders and quality of the health system), maternal mortality, and per capita national income.</p><p><strong>Results: </strong>Although prevalence of overweight had increasing trend from 2000 to 2012, its trend was changed to decrease after 2012. Spearman's rho correlation analysis for all years (2000-2024) showed that exclusive breastfeeding was significantly and positively correlated with overweight (r = 0.676; p < 0.01). For 2000-2012 period in which overweight trend was increasing, exclusive breastfeeding was significantly and positively correlated with overweight (r = 0.939; p < 0.01) in addition to maternal mortality (r=-0.993; p < 0.01) and GDP (r = 0.972; p < 0.01). For 2012-2024 time period, correlation between exclusive breastfeeding and overweight was negative, but correlation coefficient was insignificant (p > 0.05). Year controlled partial correlation analysis results showed that exclusive breastfeeding was significantly and negatively correlated with overweight (r=-0.698; p < 0.01). Overweight was also significantly correlated with health expenditure (r = 0.444; p < 0.05), maternal mortality (r=-0.677; p < 0.01) and GDP (r=-0.572; p < 0.01). Generalized linear model results showed that effect of exclusive breastfeeding (B = 0.060; p < 0.05) and maternal mortality (r=-0.277; p < 0.01) were statistically significant.</p><p><strong>Conclusion: </strong>The effect of breastfeeding on weight monitoring and diet in breastfed children must be well understood, and causal interpretations regarding breastfeeding reducing childhood overweight should be avoided. Therefore, while we encourage breastfeeding in the fight against obesity, we believe it should not be viewed as a single tool for combating obesity, and must be supported by confounders.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multivariable regression modelling of structural, intermediary and demographic determinants of health literacy: evidence from unaccompanied migrants and statelessness-prone individuals in Ghana.","authors":"Ebenezer Asare Aboagye, Dina Adei, Williams Agyemang-Duah","doi":"10.1186/s41043-026-01385-9","DOIUrl":"10.1186/s41043-026-01385-9","url":null,"abstract":"<p><strong>Background: </strong>Health literacy is acknowledged as a critical determinant of equitable health outcomes. However, its social patterning among populations experiencing legal precarity, irregular mobility, and administrative exclusion remains insufficiently examined in the sub-Saharan African context, particularly in Ghana. This study addresses this gap by examining health literacy among unaccompanied migrants and persons prone to statelessness in Ghana.</p><p><strong>Methods: </strong>Data were derived from a cross-sectional survey conducted in two purposively selected districts in Ghana, characterized by mobile and heterogeneous populations. Health literacy was assessed using the HLS19-Q12 instrument and analyzed in SPSS (version 27). Analyses comprised descriptive statistics and binary logistic regression modelling. Statistical significance was set at p < 0.05, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported.</p><p><strong>Results: </strong>Health literacy was predominantly low, with 62.6% of respondents reporting inadequate literacy, while 37.4% demonstrated sufficient literacy. In the multivariable binary logistic regression analyses, sufficient health literacy was significantly associated with formal employment (AOR = 4.05, p < 0.001, CI: 2.21-7.42), ease of healthcare access (AOR = 2.52, p < 0.01, CI: 1.47-4.34) and language proficiency particularly in Akan/Twi (AOR = 3.49, p < 0.01, CI: 1.43-8.48), Ga/Dangme (AOR = 4.76, p < 0.001, CI: 1.61-14.13), and Gonja/Dagbani (AOR = 4.28, p < 0.001, CI: 1.63-11.21). Other factors including social network, place of residence, health information sources, age, and access to basic amenities equally demonstrated significant associations but with comparatively modest effects.</p><p><strong>Conclusion: </strong>These findings suggest that health literacy among mobile and documentation-insecure populations in Ghana is structured less by demographic factors than by structural and intermediary conditions. While employment, language proficiency, and healthcare access are key determinants, other factors also contribute. Effective interventions therefore require coordinated policy responses that move beyond individual barriers and group identity to address these intersecting constraints that condition access to enabling resources.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the connection between life's crucial 9 and metabolic syndrome: the weight-adjusted waist index as a mediating factor.","authors":"Jiahao Wang, Lei Ren, Yongli Han, Lunuan Wang, Chengdong Sun, Rong Jiang, Shuming Guo","doi":"10.1186/s41043-026-01384-w","DOIUrl":"10.1186/s41043-026-01384-w","url":null,"abstract":"<p><strong>Background: </strong>Research has shown that the health status of the cardiovascular system and obesity may be associated with Metabolic Syndrome (MetS) to some extent. However, the exact nature of the relationship between the three has not yet been established. Life's Crucial 9 (LC9) represents a contemporary metric for comprehensive cardiovascular health evaluation. Separately, the Weight-Adjusted Waist Index (WWI) serves as an emerging anthropometric indicator that differs fundamentally from BMI by normalizing waist circumference through weight standardization, leading to its growing adoption in current research. This study sought to elucidate the association between LC9 and MetS and to evaluate the potential role of WWI in the association.</p><p><strong>Methods: </strong>This investigation drew upon data from the National Health and Nutrition Examination Survey (NHANES) to conduct a cross-sectional analysis. The association between LC9 and MetS was assessed through multiple analytical techniques, employing multivariate logistic regression, restricted cubic splines (RCS), and subgroup stratification. Furthermore, mediation modeling was implemented to quantify the extent to which WWI might account for the observed relationship.</p><p><strong>Results: </strong>This study included 25,399 participants, among whom 7,811 reported MetS events. After adjusting for all variables using multivariate logistic regression, each 10-unit increase in LC9 was associated with a 31% reduction in the prevalence of MetS (OR = 0.69, 95% CI: 0.66 to 0.72), while each 1-unit increase in WWI was associated with a 1.11-fold increase in the prevalence of MetS (OR = 2.11, 95% CI: 1.94 to 2.29). Consistent results were observed when LC9 and WWI were adjusted to tertiles, with P for trend < 0.001. Analysis using RCS indicated a linear negative correlation between LC9 and the prevalence of MetS. Mediation analysis indicated that WWI statistically accounted for 32.73% of the observed association between LC9 and MetS (p < 0.001).</p><p><strong>Conclusion: </strong>This study demonstrates a significant inverse association between LC9 and MetS, with WWI statistically accounting for a substantial portion of this association. These results highlight the interplay between cardiovascular health metrics and metabolic disorders, thereby suggesting that favorable body composition profiles are associated with lower MetS prevalence in the context of higher cardiovascular health.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed food and risk of cholecystitis and cholelithiasis: a prospective cohort study.","authors":"Peiyi Zheng, Feifan Wang, Kaiyang Zhang, Jiayi Qian, Qiaoqiao Fang, Jing Guo, Jiayu Li, Ding Ye, Yingying Mao, Xiaohui Sun","doi":"10.1186/s41043-026-01390-y","DOIUrl":"10.1186/s41043-026-01390-y","url":null,"abstract":"<p><strong>Background and aims: </strong>The global rise in ultra-processed food (UPF) consumption has been linked to several chronic diseases. However, its association with cholecystitis and cholelithiasis remains underexplored.</p><p><strong>Methods: </strong>This prospective cohort study included 154,376 UK Biobank participants. UPF consumption (assessed as percentage of total food weight, g/day) was categorized by the NOVA classification using Oxford WebQ-based 24-hour dietary assessments. Cox proportional hazards models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cholecystitis and cholelithiasis risk with the adjustments for demographics, lifestyle factors, nutrients, and comorbidities. Restricted cubic splines analyses were used to evaluate dose-response relationships.</p><p><strong>Results: </strong>During a median follow-up of 13.2 years, higher UPF intake was associated with increased risks of cholecystitis and cholelithiasis. Participants in the highest quartile of UPF consumption (Q4) had higher risks of cholecystitis (HR:1.20, 95% CI: 1.07-1.34, P = 0.001) and cholelithiasis (HR:1.15, 95% CI: 1.05-1.25, P = 0.002), compared with the lowest quartile. Sensitivity analyses confirmed the robustness of these findings. Nonlinear relationships were observed for both diseases, with risk increasing beyond specific UPF consumption thresholds (27% of total food weight for cholecystitis and 16% for cholelithiasis). Additionally, subgroup analyses revealed inverse associations of breakfast cereals with both cholelithiasis and cholecystitis, and of ultra-processed breads with cholelithiasis, whereas snacks and desserts were positively associated with cholelithiasis risk.</p><p><strong>Conclusions: </strong>Higher total UPF consumption was independently associated with elevated risks of cholecystitis and cholelithiasis, although inverse associations were observed for certain subgroups such as breakfast cereals and ultra-processed breads. However, reducing snacks and desserts may help lower biliary disease risk, but further studies are needed to clarify the role of specific UPF subgroups.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting and identifying determinants of stunting among school-aged children in Ethiopia: a machine learning approach.","authors":"Shibiru Jabessa Dugasa, Merga Abdissa Aga","doi":"10.1186/s41043-026-01401-y","DOIUrl":"10.1186/s41043-026-01401-y","url":null,"abstract":"<p><strong>Background: </strong>Childhood stunting remains a major public health concern, reflecting chronic undernutrition and long-term socioeconomic disadvantage. Among school-aged children, stunting is associated with impaired physical growth, reduced cognitive development, and poorer educational outcomes. Traditional statistical approaches, such as logistic regression, have been widely used to examine factors associated with stunting; however, their ability to capture complex and nonlinear relationships is limited. Machine learning (ML) methods provide a flexible alternative for modeling such relationships.</p><p><strong>Objective: </strong>This study aimed to model and classify stunting among school-aged children in Ethiopia using school- and household-level data, and to compare the performance of machine learning algorithms with multivariable logistic regression.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using secondary data from Round 5 (2016-2017) of the Young Lives study in Ethiopia. Stunting was defined as a binary outcome based on World Health Organization height-for-age Z-score criteria. Several machine learning algorithms, including Random Forest, Support Vector Machine, and Gradient Boosting Machine, were implemented. Model performance was evaluated using accuracy, sensitivity, specificity, F1-score, and area under the receiver operating characteristic curve (AUC). Variable importance measures were used to identify predictors contributing to model performance. To avoid potential circularity, anthropometric variables closely related to the outcome (e.g., child weight) were excluded from the final models.</p><p><strong>Results: </strong>The Random Forest model demonstrated modestly improved performance compared with logistic regression and other machine learning methods, and its performance was evaluated using accuracy, sensitivity, specificity, AUC, and F1-score. Key predictors included school type, household wealth index, literacy-related indicators, and region of residence. Notable regional variation in stunting classification was observed, suggesting the influence of broader socioeconomic and environmental conditions.</p><p><strong>Conclusion: </strong>Machine learning models, particularly Random Forest, showed slightly better performance than conventional logistic regression in classifying stunting among school-aged children in Ethiopia. The identified predictors highlight the multifactorial and context-dependent nature of stunting. These findings support the use of ML approaches as complementary analytical tools for understanding patterns of child undernutrition, although their application for prediction should be interpreted within the limitations of cross-sectional data.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of starchy and non-starchy vegetable intake with depression, anxiety, stress, chronotype, and sleep quality among iranian women with overweight or obesity: a cross-sectional study.","authors":"Zahra Roumi, Atieh Mirzababaei, Faezeh Abaj, Cain C T Clark, Paria Jadidi, Reyhaneh Rasekhmagham, Khadijeh Mirzaei","doi":"10.1186/s41043-026-01392-w","DOIUrl":"10.1186/s41043-026-01392-w","url":null,"abstract":"<p><strong>Background: </strong>Starchy vegetables may influence psychological well-being, circadian alignment, and sleep quality through their glycemic characteristics and related metabolic effects. In contrast, non‑starchy vegetables, which differ substantially in nutrient density and bioactive compounds, may affect these outcomes through alternative physiological pathways. Despite these distinct nutritional profiles, evidence comparing their separate associations with mental health and sleep-related patterns is limited. This study explored these relationships among overweight and obese women.</p><p><strong>Methods: </strong>In this cross-sectional study, 391 overweight and obese women aged 18-48 years were recruited using a cluster sampling strategy from community health centres. Data collection was conducted through structured face‑to‑face interviews performed by trained nutritionists. Mental health indicators (depression, anxiety, and stress) were assessed using the Persian DASS‑21, sleep quality was evaluated using the PSQI, and circadian preference was measured using the MEQ. Dietary intake was obtained through a validated 147‑item food frequency questionnaire (FFQ). Anthropometric measurements, blood samples, biochemical markers, physical activity, and demographic information were collected following standardized procedures.</p><p><strong>Results: </strong>The study included 391 women, with a mean age of 38.08 ± 8.61 years in the high non-starchy vegetable intake group and 35.31 ± 9.59 years in the low non-starchy vegetable intake group, all classified as overweight or obese. Participants with higher non‑starchy vegetable intake exhibited significantly lower odds of depression (adjusted OR = 0.40, 95% CI = 0.20-0.79, P < 0.001) and stress (adjusted OR = 0.30, 95% CI = 0.14-0.85, P = 0.02). Higher non‑starchy vegetable consumption was also associated with improved sleep quality (adjusted OR = 0.38, 95% CI = 0.19-0.77, P = 0.007). Furthermore, increased starchy vegetable intake was inversely associated with the morning-type chronotype (adjusted OR = 0.27, 95% CI = 0.09-0.83, P = 0.02) after full adjustment.</p><p><strong>Conclusions: </strong>Higher non-starchy vegetable intake was associated with lower odds of depression, stress, and poor sleep quality, while greater starchy vegetable consumption was linked to a lower likelihood of morning-type chronotype. Increasing non-starchy vegetable intake may support psychological well-being and sleep health, though longitudinal studies are needed to confirm causality.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and predictors of loss to follow-up among adults receiving ART in Metekel Zone, Northwest Ethiopia: a retrospective cohort study.","authors":"Temesgen Desalegn Balda, Abraham Lomboro Dimore, Chaltu Fikru Biyana","doi":"10.1186/s41043-026-01387-7","DOIUrl":"10.1186/s41043-026-01387-7","url":null,"abstract":"<p><strong>Background: </strong>Loss to follow-up (LTFU) remains a significant global public health challenge, particularly among patients receiving antiretroviral therapy (ART). There is paucity of information on incidence and predictors of LTFU in the Metekel zone, which limits the ability to monitor the effectiveness intervention.</p><p><strong>Objective: </strong>To assess the incidence and identify the predictors of loss to follow-up among adult people living with HIV at public health facilities in the Metekel Zone, Northwest Ethiopia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among 540 people living with HIV who enrolled in ART from June 28, 2017, to June 27, 2022, in the Metekel Zone. The study was conducted in one public hospital and eight public health centers. Patient records were randomly selected and extracted using a structured checklist. The Kaplan-Meier curves were compared using the log-rank test, and the Cox proportional hazard model was used to identify the independent predictors of LTFU. The strength of the association was measured using adjusted hazard ratio (AHR) along with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 540 participants, 304 (56.3%) were females and the mean (SD) age participants was 35.7(12.41) years. The overall LTFU incidence rate was 15.12 (95% CI: 12.9-17.6) per 100 person-years. Tuberculosis infection at baseline (AHR: 2.12 95% CI: 1.33 - 3.38), underweight at ART initiation (AHR: 5.36, 95% CI: 3.46-8.31), poor ART adherence (AHR: 2.14, 95% CI: (1.32 - 3.46), and most recent viral load > 1000 copies/mL (AHR: 2.71, 95% CI: 1.55 - 4.72) were identified significant predictors of LTFU.</p><p><strong>Conclusion: </strong>The observed LTFU incidence rate among adults receiving ART in Metekel Zone was notably higher than documented in prior studies. Hence, enhanced monitoring and support strategies should target patients with baseline tuberculosis infection, poor treatment adherence, underweight at baseline, and high viral load, particularly within the first year of treatment initiation. In addition, effective strategies to improve patient retention in HIV care should be designed considering the identified risk factors.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a framework for primary health care resilience in pandemic conditions for Iran.","authors":"Naser Derakhshani, Erfan Kharazmi, Seyedeh Narges Pouyan, Azam Choopani, Yousef Pashaei Asl, Nasrin Moradi","doi":"10.1186/s41043-026-01389-5","DOIUrl":"10.1186/s41043-026-01389-5","url":null,"abstract":"<p><strong>Introduction: </strong>Primary Health Care (PHC) services are people's first point of contact with the health system. PHC helps to ensure health system resilience and health community, playing a vital role in preventing and detecting diseases early, especially during pandemics. By doing so, PHC helps reduce mortality rates significantly. This study aimed to explore the challenges affecting the resilience of PHC during pandemics and to develop a Framework for strengthening that resilience.</p><p><strong>Methods: </strong>This qualitative research was conducted in three phases in 2024. In the first phase, semi-structured interviews were held with 14 experts in PHC that originated from IRAN to identify key challenges in PHC service delivery during pandemics. In the second phase, an initial resilience Framework was designed through an expert panel involving five specialists. In the final phase, the Framework was validated using a one-round Delphi process with 21 experts. Data were analyzed using MAXQDA 2020.</p><p><strong>Findings: </strong>The analysis revealed six main themes: processes, human resource management, financial resource management, infrastructure and equipment, sociocultural factors, and policy and planning. From the data, 20 sub-themes and 102 initial codes were extracted. Based on expert feedback, a proposed PHC resilience Framework was developed and validated through the Delphi method, achieving a consensus score of 0.90.</p><p><strong>Conclusion: </strong>Health system managers and policymakers can apply the identified components of the proposed Framework to improve PHC resilience. Key strategies include optimizing financial resource allocation, expanding human resource capacity, enhancing workforce preparedness for pandemic response, promoting public awareness, strengthening social support systems, and advancing digital health and telemedicine infrastructure. These measures can help ensure the continuity of PHC services and enhance preparedness for future pandemics.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}